Satya Vijay Chigurupati1, Mridula Shukla2, Manoj Pandey3. 1. Department of Surgical Oncology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, India. 2. Dr. Lal Path Lab, Varanasi, India. 3. Department of Surgical Oncology, Institute of Medical Science, Banaras Hindu University, Varanasi, 221005, India. manojpandey66@gmail.com.
Abstract
INTRODUCTION: Isolated primary sacral diffuse large B cell non-Hodgkin's lymphoma is a very rare entity, and only 11 cases have been reported previously. CASE PRESENTATION: A 36-year-old man was referred with low backache and radiculopathy pain with a clinico-radiological and cytological diagnosis of sacral metastasis. Histopathological examination and immunohistochemistry of image-guided tissue core biopsy from the sacral mass confirmed it as high-grade diffuse large B cell lymphoma (DLBCL). With normal blood counts and bone marrow, and no lesions elsewhere on imaging, he was staged IAE and received 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) regimen chemotherapy followed by radiotherapy. The patient has completed a 3-year follow-up and is doing well with yearly imaging showing no evidence of active disease or recurrence. CONCLUSIONS: The case shows the importance of an image-guided core biopsy and immunohistochemistry over a fine needle aspiration cytology in select cases as it can alter the treatment and outcome in patients. Because of rarity, the treatment and prognosis in primary sacral NHL is not still very clear as it is treated as per the guidelines of treatment of bone lymphoma.
INTRODUCTION: Isolated primary sacral diffuse large B cell non-Hodgkin's lymphoma is a very rare entity, and only 11 cases have been reported previously. CASE PRESENTATION: A 36-year-old man was referred with low backache and radiculopathy pain with a clinico-radiological and cytological diagnosis of sacral metastasis. Histopathological examination and immunohistochemistry of image-guided tissue core biopsy from the sacral mass confirmed it as high-grade diffuse large B cell lymphoma (DLBCL). With normal blood counts and bone marrow, and no lesions elsewhere on imaging, he was staged IAE and received 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) regimen chemotherapy followed by radiotherapy. The patient has completed a 3-year follow-up and is doing well with yearly imaging showing no evidence of active disease or recurrence. CONCLUSIONS: The case shows the importance of an image-guided core biopsy and immunohistochemistry over a fine needle aspiration cytology in select cases as it can alter the treatment and outcome in patients. Because of rarity, the treatment and prognosis in primary sacral NHL is not still very clear as it is treated as per the guidelines of treatment of bone lymphoma.
Entities:
Keywords:
Diffuse large B cell lymphoma; Non-Hodgkin's lymphoma; Primary bone lymphoma; Sacrum
Authors: Hans Roland Dürr; Peter Ernst Müller; Erhard Hiller; Markus Maier; Andrea Baur; Volkmar Jansson; Hans Jürgen Refior Journal: Arch Orthop Trauma Surg Date: 2002-02 Impact factor: 3.067
Authors: Victor Housset; Philippe Anract; Antoine Babinet; Guillaume Auberger; David Biau Journal: World J Surg Oncol Date: 2022-05-28 Impact factor: 3.253